AUTHOR=Li Youran , Xiao Pei , Cao Rong , Le Jun , Xu Qiao , Xiao Fangfei , Ye Lin , Wang Xufei , Wang Yizhong , Zhang Ting 

TITLE=Effects and microbiota changes following oral lyophilized fecal microbiota transplantation in children with autism spectrum disorder

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1369823

DOI=10.3389/fped.2024.1369823

ISSN=2296-2360

ABSTRACT=Background and purpose: Autism spectrum disorder (ASD) is a group of heterogeneous neurodevelopmental disorders characterized by core features in social communication impairment and restricted, repetitive sensory-motor behaviors. This study aimed to further investigate the utilization of fecal microbiota transplantation (FMT) in children with ASD, evaluate the effect of FMT and analyze the alterations in bacterial and fungal composition within the gut microbiota.
Methods: A total of 38 children diagnosed with ASD participated in the study. The dosage of the FMT treatment was determined based on a ratio of 1g of donor stool per 1kg of recipient body weight, with a frequency of once every 4 weeks for a total of 12 weeks. In addition, 30 healthy controls (HC) were included. The clinical efficacy of FMT was evaluated, while fecal bacteria and fungi was determined using 16S rRNA and ITS gene sequencing methods.
Results: Median age of the 38 children with ASD was 7 years, 84.2% (32 of 38) were boys and 81.6% (31 of 38) exhibited GI symptoms. Sample collections and assessments were conducted at baseline (week 0), post-treatment (week 12) and follow-up (week 20). At the end of the follow-up phase after FMT treatment, the autism behavior checklist scores decreased by 23% from baseline, and there was a 10% reduction in scores on the childhood autism rating scale, a 6% reduction in scores on the social responsiveness scale and a 10% reduction in scores on the sleep disturbance scale for children. Comparisons between children with ASD and HC revealed statistically significant differences in microbial abundance before and after FMT. Blautia, Sellimonas, Saccharomycopsis and Cystobasidium were more abundant in children with ASD than in HC, while Dorea were less abundant. After FMT treatment, levels of Blautia, Sellimonas, Saccharomycopsis and Cystobasidium decreased, while levels of Dorea increased. Moreover, the increased abundances of Fusicatenibacter, Erysipelotrichaceae_UCG-003, Saccharomyces, Rhodotorula, Cutaneotrichosporon and Zygosaccharomyces were negatively correlated with the scores of ASD core symptoms. 
Conclusions: Oral lyophilized FMT could improve GI and ASD related symptoms, as well as sleep disturbances, and alter the gut bacterial and fungal microbiota composition in children with ASD.